go back

Arizona rates for HCPCS J1572

Injection, immune globulin, (Flebogamma/Flebogamma Dif), intravenous, nonlyophilized (e.g., liquid), 500 mg

Facilitymedian $117 · 10th–90th $54–$3090%10%20%10th90th$117Professionalmedian $52 · 10th–90th $50–$620%50%10th90th$52$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $52.48 / $61.66
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $199.53 / $354.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $102.33 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $63.10 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $91.20 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $58.88